What is osteoarthritis?

Arthritis, also called osteoarthritis, is a breakdown of the cartilage that cushions your joints. When the cartilage wears down, your bones rub against each other. This causes pain and stiffness. Many people have some arthritis as they age. Arthritis most often affects the joints of the spine, hands, hips, knees, or feet.

Arthritis never goes away completely. But medicine and home treatment can help reduce pain and help you stay active.

It's hard to know if and how fast arthritis will get worse. Symptoms may come and go, stay the same, or get worse over time.

At first, you may have pain only when you are active. Over time, you may also have pain when you are resting. Joints can become stiff, and you may lose the full range of motion you used to have. Joints can become misshapen over time. This is more likely in the small joints of the hands and feet.

Although there is no cure for arthritis, treatment can help slow the disease and relieve symptoms. Most people can manage their symptoms with medicine and lifestyle changes. But in a few people, arthritis may get so bad that they decide to have surgery.

When you have arthritis, even simple, everyday movements can hurt. Walking a few steps, opening a door, and even combing your hair can be hard. Symptoms may be mild to severe and may include:

• Pain in your joints.
• Stiffness when you get up in the morning.
• Muscle weakness around the joints.
• Swelling in the joints.
• Joints that are deformed and look like they are the wrong shape.
• Reduced range of motion and loss of use of the joint.
• Cracking and creaking in your joints.
• Sleep problems.

You can have symptoms in any joint. But they most often occur in the hands, hips, knees, feet, and sometimes the spine. Most often, arthritis only occurs in one set of joints, such as the knees. But it may affect more than one area of the body, such as both the knees and the hands.

Treatment for arthritis includes pain medicines and self-care. Self-care includes exercise and activity, staying at a healthy weight, putting ice or heat on a sore joint, and resting. For severe arthritis, surgery is an option.

Doctors use osteotomy if destruction of the knee cartilage mainly affects a single disc of cartilage: the disc (meniscus) either on the inner part or on the outer part of the knee joint.

Osteotomy is an appropriate treatment for younger, active people with osteoarthritis who are able to delay a total joint replacement.

You can take steps to help prevent osteoarthritis. For example, stay at a healthy weight, be active, and protect your joints. If you already have arthritis, these same steps may keep it from getting worse.

Your doctor can often diagnose arthritis by asking you questions about your joint pain and other symptoms and examining you. You may also have X-rays and blood tests. Blood tests can help make sure another disease isn't causing your symptoms.

Medicine can help reduce your symptoms of arthritis and allow you to do your daily activities. But medicine doesn't cure arthritis or slow the time it takes for cartilage to break down.

Medicines that work for some people don't work for others. Be sure to let your doctor know if the medicine you're taking doesn't help. You may need to try several kinds of medicines to find one that works for you.

The goal of medicine is to:

• Manage pain with the fewest side effects.
• Keep your joints working and moving well. If pain keeps you from moving your joints, it can cause the ligaments, tendons, and muscles that move your joints to shorten and become tight and weak.

The type of medicine depends on how bad your pain is. For example:

• For mild to moderate pain, you can try over-the-counter pain medicine. These include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil or Motrin) or naproxen (Aleve). Acetaminophen, such as Tylenol, may also help.
• For moderate to severe pain, you may need stronger pain medicine, such as opioids.

Medicine choices

Medicines used to treat arthritis include:

• NSAIDs to reduce pain and swelling.
• Acetaminophen to help relieve pain.
• Tramadol to help relieve pain.
• Steroid shots in the joint to reduce swelling.
• Some antidepressants, such as duloxetine, to help relieve pain.
• Opioids to relieve severe pain.

Medicine that you put on your skin (topical) may relieve pain for a short time. These include topical NSAIDs, capsaicin, and pain-relieving creams.

Arthritis can be managed by:

• A family medicine physician.
• An internist.
• A nurse practitioner.
• A physician assistant.
• A rheumatologist.

Other health professionals may be part of the treatment team, such as:

• A physiatrist.
• A pain management specialist.
• An orthopedic surgeon.
• A physical therapist.
• An occupational therapist.
• A dietitian.
• A social worker.

There are things you can do to manage the symptoms of arthritis and to help prevent the disease from getting worse. You can:

Use pain medicine.

If your pain is mild, over-the-counter medicines may help. These include nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen.

Make lifestyle changes.

These changes include getting enough rest, staying active, and staying at a healthy weight. Staying at a healthy weight is very important if you have arthritis in your legs or feet.

Use assistive devices.

Devices can take the stress and weight off your joints and make it easier for you to hold objects, open and close things, and walk. Devices may include a cane, a raised toilet seat, and large-handled utensils.

Try heat or cold on sore joints.

But don't use heat if the joint is swollen or hot.

Change how you do things.

Changes could include modifying your home, protecting your joints, and changing activities.

In most cases, people can manage their arthritis symptoms with medicine and lifestyle changes. But surgery may be an option if:

• You have very bad pain.
• You have lost a lot of cartilage.
• You have tried medicine and other treatments, but they haven't helped.
• Your overall health is good.

Surgery choices

Types of surgery for arthritis include:

Arthrodesis.

This joins (fuses) two bones in a damaged joint so that the joint won't bend. Doctors may use it to treat arthritis of the spine, ankles, hands, and feet. In rare cases, it's used to treat the knees and hips.

Arthroscopy.

This is sometimes tried to smooth a rough joint surface or remove loose cartilage or bone fragments. But in general it has not been shown to be helpful for arthritis.

Hip resurfacing surgery.

This is most often done in younger, more active people who have pain and disability caused by a badly damaged hip.

Joint replacement.

This is done when other treatments haven't worked and damage to the joint can be seen on X-rays. It involves surgery to replace the ends of bones in a damaged joint. The surgery creates new joint surfaces. The joints that are replaced most often are the hip, knee, and shoulder. But other joints such as the elbow and the ankle can also be replaced.

Osteotomy.

This is done to correct certain defects in the hip and knee. In most cases, it's done in active people younger than 60 who want to delay surgery to replace a hip or knee.

Small joint surgery.

Surgery is more common on the larger joints, such as the hip and knee. But if pain in the small joints of the hands or feet is so bad that the person can't use those joints, surgery may help.

Living with osteoarthritis can be stressful. You may worry about how it may change your life, work, and relationships.

It's hard to know how fast your arthritis may progress. Your symptoms may come and go, stay the same, or get worse over time. Some days you may feel fine and be able to do the things you need—and want—to do with little pain. Other days the pain may be too much for you to do simple tasks like getting dressed or brushing your teeth.

Some people feel overwhelmed, tired, and angry. They may be afraid that they might become disabled and not be able to care for themselves. They may even wonder if they can keep working. It's okay if you have any of these feelings. Most people who have arthritis feel this way at one time or another.

Some people with arthritis also feel down or depressed. They may describe this as feeling "depressed," "unhappy," "short-tempered," "blue," or "down in the dumps." If you feel like this most of the time, tell your doctor. Treating these symptoms may help you feel better and make it easier for you to do your daily tasks.

You're more likely to have arthritis if:

You're overweight.

Extra weight adds stress on your joints and can change the normal shape of the joint.

You have or had a joint injury.

A single major injury to a joint or several minor injuries can cause cartilage damage over time.

You're not active.

Lack of exercise can cause your muscles and joints to get weak and stiff.

You have a family history of arthritis.

If someone in your family has arthritis, you may be more likely to have it too.

Other things that may put you at risk include:

Getting older.

Age isn't a direct cause of arthritis. But as you get older, you're more likely to have symptoms.

Loose or odd-shaped joints.

Knees that bend outward (bowleg) or knees that bend toward each other (knock knees), for example, can cause an imbalance in the joints because the cartilage wears down at an uneven rate.

A lot of people use some form of complementary medicine to treat osteoarthritis. These treatments are often used along with standard care to help relieve their arthritis symptoms.

Some of these treatments may help you move more easily and deal with the stress and pain of arthritis. But in some cases, not much is known about how safe they are or how well they may work.

Be sure to tell your doctor about any complementary treatments you use or want to use. The doctor can tell you about the possible benefits and side effects of these treatments and whether these treatments may interfere with your standard care. For example, some diet supplements and herbal medicines may cause problems if you take them with another medicine.

Complementary treatments

Acupunctureand massage.

Some people find treatments like acupuncture and massage helpful for their knee arthritis. But they may not help any more than a placebo (fake treatment) does.

Mind-body practices.

Mind-body practices, such as yoga, tai chi, and qi gong, can help reduce stress and relax your mind and muscles. Stress can make pain worse. So learning to control stress and relax may help with pain.

Taping of the knee.

Taping uses tape that sticks to the knee to help keep the kneecap in place and relieve pain. You can do taping at home. But first have your doctor or physical therapist show you the right way to put it on.

Braces for the knee.

Braces can help shift weight off the part of your knee that hurts. It's not clear how well these work, but there isn't a lot of risk in trying them.

Transcutaneous electrical nerve stimulation (TENS).

TENS uses a mild electrical current to reduce pain.

Dietary supplements.

Many dietary supplements, such as glucosamine and chondroitin, have been tried. But there is not evidence that they help much with arthritis pain or stiffness. Turmeric is a supplement that is being studied and may have some benefit.

When you have arthritis, the cartilage that cushions and protects your joints breaks down and wears away. When it breaks down, the bones rub together and cause damage and pain. Experts don't know why this breakdown in cartilage happens.

In some cases, arthritis is caused by other conditions that damage cartilage.

Osteoarthritis is the type of arthritis that many people get as they age. It happens when the cartilage that cushions your joints gradually breaks down and the bones rub against each other. This causes damage and pain. Osteoarthritis is usually called arthritis.

Physical therapy (PT) can help make daily tasks and activities easier. A physical therapist can help you with walking, grabbing and holding objects, or going up stairs. In PT, you also learn which types of exercises are best for you.